Severe drop in childbirth rates across the Nordics

Discussing birth rates and adoptions in relation to the workforce can seem an abstract exercise. Many other factors influence the size of the workforce. Compared to migration, unemployment, sick leave, retirement age and the number of part-time workers, adoptions and fertility treatments do not matter that much. 

It will also take up to 25 years before the children who are born today enter into the labour market, of course. But there are some other, more pressing consequences: New parents get parental leave and disappear from the labour market for a year.

Only a few years after Louise Brown became the first test-tube baby in 1978, Nordic couples struggling with infertility were able to undergo assisted fertilisation, which involved extracting an egg from the woman's body, fertilizing it, and then re-implanting it.

170,000 children have been born as a result of assisted fertilisation in the Nordic region, according to the Committee of Nordic Assisted Reproductive Technology and Safety CoNARTaS.

The register lists both children born from ART (assisted reproduction technology) and the 7,850,000 children who were born without any assistance. The statistics run until 2015 and also include all mothers. 

The most up-to-date statistics are found at the European Society of Human Reproduction and Embryology, ESHRE, however. They gather data from all of the European countries. These were the figures from five years ago, with a few gaps in the statistics, according to ESHRE:

The statistics are from 2019 for Denmark, Norway and Sweden, and from 2018 for Finland and Iceland. The percentages compared with all births are missing for Norway. Source: ESHRE.

As the statistics shows, nearly 15,000 children are born in the Nordics as a result of assisted fertilisation per year. 

The proportion looks set to rise. According to the World Health Organisation, 17.5 per cent of the world’s women and men struggle to conceive. The proportion is slightly higher in high-income countries compared to low-income ones. 

Spain had the highest level of children born through assisted fertilisation in Europe in 2019, with 8.9 per cent.

One explanation for the falling fertility rates is that women wait longer to have children. The fall in fertility rates might not seem very dramatic. For the whole of the EU, the number of children born per woman has varied between 1.43 at the bottom and 1.57 at the top over the past 20 years. 

Fertility is measured in the number of live births per woman in a country. Source: Eurostat.

In a country with low child mortality rates, women need to have 2.1 children on average in order to maintain the country’s population level.

Historically, the most dramatic change occurred between the early 1900s, when Swedish women gave birth to four children on average, and the mid-1930s, when that number had fallen to 1.75. After that, things have gone a little up and down, but today’s level of 1.45 children per woman is the lowest since 1749 when the statistics started.

The lowest number of the Nordics, is in Finland, whith 1.32 children per woman. In Denmark the number was 1,55 and in Iceland 1.59. 

Source: SCB

It is the same story in the rest of the Nordic region. Fertility has fallen roughly equally in all the Nordic countries and across all educational groups, according to the Norwegian Institute of Public Health, FHI. 

“This parallel reduction – even though these countries were hit in different ways of the ‘economic crisis’ and have seen different economic developments – could indicate that the fall in fertility rates does not depend on people’s economic situation,” writes FHI. 

Improving families with children’s economy seems to have only a marginal effect on childbirth. South Korea has the lowest fertility rate in the world at 0.72 children per woman. The country has spent 270 billion dollars since 2006 to try to increase childbirth, without success.  

In that situation, increased investment in assisted fertilisation may seem like a win-win measure. Childless individuals get their longed-after children and the state, in turn, gets new taxpayers (a couple of decades later).

But you also have to calculate what would have happened if there was no access to assisted fertilisation. Adoption used to be an alternative for childless people, mainly from abroad. But the number of international adoptions has fallen for various reasons.

In the graph above we have compared international adoptions in Sweden and Norway. Around 1,000 children were adopted in Sweden and 600 in Norway every year in the 20 years between 1986 and 2006. Then the number falls rapidly.

In total, between 2006 and 2022, 3,377 children were adopted from abroad to Norway. If the level had stayed steady from before the adoptions started falling, 9,600 children would have been adopted to Norway. 

Assisted fertilisation has therefore to a certain extent replaced adoptions. The technology has improved in many ways. But that does not mean the number of successful pregnancies has increased. On the contrary – it has fallen. 

The explanation is that many doctors have stopped using the method of introducing multiple embryos during the IVF treatment. This used to increase the chances of pregnancy but also carried increased risks for both the fetuses and the women.  

So today, only one embryo is usually introduced into the woman’s womb. In 2023, Iceland became the first country in Europe that saw no twin or triplet births at all as a result of fertility treatment. The statistics for twins and triplets look like this across the EU:  

The number of transferred embryos in EU. One embryo is becoming the norm, but as a result fewer babies are born. Source: ESHRE

This has led to a stagnation and even a fall in the number of live births.

Nearly 50 years after the birth of Louise Brown, the first children born through assisted fertilisation will also start to retire. That is also the case, of course, for the large group of children who were adopted from abroad up until 2005. 

After that, there will not be any temporary increases in the workforce for these two reasons. But then the question arises whether there will be more people born through assisted fertilisation who retire than there are new IVF children born. 

Investing in assisted fertilisation to increase the workforce may have a marginal effect for a few years. But it is hardly a miracle cure – except for the fortunate parents.